双胎贫血多血质序列症8例临床分析  

Twin Anemia-Polycythemia Sequence: a Clinical Analysis of 8 Cases

作　　者：李南[1] 陈敏[1] 王佳燕[1] 宋艳琴[1] 刘子建 陈敦金[1] 

机构地区：[1]广州医科大学附属第三医院,广东广州510150 [2]香港领峰医务中心产前诊断中心,香港999077

出　　处：《实用妇产科杂志》2016年第9期689-693,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨双胎贫血多血质序列症(TAPS)临床特点、治疗及近期预后,以提高临床医生对本病的认识。方法:对广州医科大学附属第三医院胎儿医学中心2013年8月至2016年3月诊断为TAPS的8例病例的临床超声检查、处理及胎儿分娩后新生儿的临床资料进行归纳研究。结果:8例TAPS病例中,7例自然发病病例平均发病孕周24.38周,分期为1期2例,分期为3期5例;1例继发于激光手术后3周为3期病例。4例采取保守期待治疗,4例采取选择性射频消融减胎治疗。保守期待治疗病例中有2例已分娩,受血胎出生平均体质量1732.50 g,平均血红蛋白(Hb)224.00 g/L,平均网织红细胞(Ret)计数0.0563;供血胎儿平均出生体质量1560.00 g,平均Hb 84 g/L,平均Ret计数0.1721。选择性减胎病例全部分娩,新生儿出生平均体质量2227.50 g。8例中除1例失访,2例仍在妊娠,其余5例生长发育及神经系统发育均位于同胎龄正常水平。结论:TAPS复杂双胎的产前超声、产后临床表现及新生儿预后差异较大,故在临床处理中应给以重视。Objective：To summarize and analyze the clinical characteristics including ultrasound features,pre- natal characteristics,diagnosis,treatments and outcomes of the Twin Anemia-Polycythemia Sequence（TAPS） to improve the recognition of the disease. Methods：We took the measurements of the monochorionic diamniotic （MCDA） twin pregnancies diagnosed in The 3^rd Affiliated Hospital of GZMU during August 2013 to March 2016, including the parameters of fetal growth,the middle cerebral artery peak systolic velocity（MCA-PSV）. Results： The gestational age at presentation was 24.38 weeks among 7 natural cases. 1 case evolved to TAPS 3 weeks after the laser therapy of TTTS. 4 of the cases accepted conservative management,4 cases had selective radio- frequency ablation reduction technique. The median birth weight of recipient twin was 1732.00 g,vs 1560.00 g in the donor twin. The median hemoglobin of recipient twin was 224.00 g/L,vs 84 g/L in the donor twin. The median reticulocyte count ratio was 0. 0563 in the recipient vs 0. 1721 in the donor. 4 cases in the elective reduction group had delivery,with the median birth weight of recipient twin was 2227. 50 g. Conclusions：TAPS is variable in the characteristics, ultrasound features and the outcome of the disease, it is important to increase awareness of TAPS.

关 键 词：单绒毛膜双羊膜囊双胎 胎儿-胎儿间输血 双胎贫血多血质序列症 

分 类 号：R714.2[医药卫生—妇产科学]